The opinion, released July 19, involves an unnamed medigap plan and an unnamed hospital organization. The medigap plan covers Medicare Part A deductibles that may be incurred during a hospital stay.
Under their arrangement, the insurer and hospital organization agree that each network hospital can provide a discount on the Medicare Part A inpatient deductible that the supplemental plan would otherwise cover for the member, according to the inspector general. Members could also get a $100 premium credit for using network hospitals.
In its advisory opinion, the inspector general determined that “the proposed arrangement poses a sufficiently low risk of fraud and abuse under the federal anti-kickback statute, and we would not impose administrative sanctions.”
The advisory opinion only applies to this specific arrangement, the inspector general said.
